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Tranexamic acid

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Tranexamic acid
Clinical data
Trade namesCyklokapron, others
Other namesTXA
License data
Routes of
By mouth, intravenous, topical
ATC code
Legal status
Legal status
Pharmacokinetic data
Elimination half-life3.1 h
CAS Number
PubChem CID
PDB ligand
CompTox Dashboard (EPA)
ECHA InfoCard100.013.471 Edit this at Wikidata
Chemical and physical data
Molar mass157.213 g·mol−1
3D model (JSmol)
  • NC[C@@H]1CC[C@H](CC1)C(O)=O
  • InChI=1S/C8H15NO2/c9-5-6-1-3-7(4-2-6)8(10)11/h6-7H,1-5,9H2,(H,10,11)/t6-,7- checkY

Tranexamic acid is a medication used to treat or prevent excessive blood loss from major trauma, postpartum bleeding, surgery, tooth removal, nosebleeds, and heavy menstruation.[6][7] It is also used for hereditary angioedema.[6][2] It is taken either by mouth or by injection into a vein.[6]

Tranexamic acid is a synthetic analog of the amino acid lysine. It serves as an antifibrinolytic by reversibly binding four to five lysine receptor sites on plasminogen. This decreases the conversion of plasminogen to plasmin, preventing fibrin degradation and preserving the framework of fibrin's matrix structure.[4] Tranexamic acid has roughly eight times the antifibrinolytic activity of an older analogue, ε-aminocaproic acid.[citation needed] Tranexamic acid also directly inhibits the activity of plasmin with weak potency (IC50 = 87 mM),[8] and it can block the active-site of urokinase plasminogen activator (uPA) with high specificity (Ki = 2 mM), one of the highest among all the serine proteases.[9]

Side effects are rare.[2] Some include changes in color vision, seizures, blood clots, and allergic reactions.[2] Tranexamic acid appears to be safe for use during pregnancy and breastfeeding.[2][10] Tranexamic acid is an antifibrinolytic medication.[11]

Tranexamic acid was first made in 1962 by Japanese researchers Shosuke and Utako Okamoto.[12] It is on the World Health Organization's List of Essential Medicines.[13] Tranexamic acid is available as a generic drug.[14]


Medical uses[edit]

A one-gram ampoule of tranexamic acid

Tranexamic acid is frequently used following major trauma.[15] Tranexamic acid is used to prevent and treat blood loss in a variety of situations, such as dental procedures, heavy menstrual bleeding, and surgeries with high risk of blood loss.[16][17]


Tranexamic acid has been found to decrease the risk of death due to any cause in people who have significant bleeding due to trauma.[18][19][20][21] It is most effective if taken within the first three hours following major trauma.[22] It also decreases the risk of death if given within the first three hours of brain injury.[23]

Menstrual bleeding[edit]

Tranexamic acid is sometimes used to treat heavy menstrual bleeding.[17] When taken by mouth it both safely and effectively treats regularly occurring heavy menstrual bleeding and improves quality of life.[4][24][25] Another study demonstrated that the dose does not need to be adjusted in females who are between ages 12 and 16.[4] In a 10-year study, tranexamic acid and other oral medicines (mefenamic acid) were found to be as effective as the levonorgestrel intrauterine coil; the same proportion of women had not had surgery for heavy bleeding and had similar improvements in their quality of life.[26][27]


Tranexamic acid is sometimes used (often in conjunction with oxytocin) to reduce bleeding after childbirth.[28] Death due to postpartum bleeding is reduced in women receiving tranexamic acid.[7]


  • Tranexamic acid is sometimes used in orthopedic surgery to reduce blood loss, to the extent of reducing or altogether abolishing the need for perioperative blood transfusion. It is of proven value in clearing the field of surgery and reducing blood loss when given before or after surgery. Drain and number of transfusions are reduced.[29][30][31]
  • In surgical corrections of craniosynostosis in children it reduces the need for blood transfusions.[32]
  • In spinal surgery (e.g., scoliosis), correction with posterior spinal fusion using instrumentation, to prevent excessive blood loss.[33][34]
  • In cardiac surgery, both with and without cardiopulmonary bypass (e.g., coronary artery bypass surgery), it is used to prevent excessive blood loss.[29]


In the United States, tranexamic acid is FDA approved for short-term use in people with severe bleeding disorders who are about to have dental surgery.[35] Tranexamic acid is used for a short period of time before and after the surgery to prevent major blood loss and decrease the need for blood transfusions.[36]

Tranexamic acid is used in dentistry in the form of a 5% mouth rinse after extractions or surgery in patients with prolonged bleeding time; e.g., from acquired or inherited disorders.[37]

In China, tranexamic acid is allowed in over-the-counter toothpastes, with six products using the drug. As of 2018, there are no limits on dosage, nor requirements for labeling the concentration.[38] 0.05% TXA in toothpaste is allowed OTC in Hong Kong.[39] <5% TXA in over-the-counter toothpaste is first patented and marketed by Lion Corporation in Japan,[40] where it is still sold.[41] Presence of unauthorized TXA has led to the Canadian recall of a Yunnan Baiyao toothpaste in 2019.[42]


There is not enough evidence to support the routine use of tranexamic acid to prevent bleeding in people with blood cancers.[43] However, there are several trials that are currently assessing this use of tranexamic acid.[43] For people with inherited bleeding disorders (e.g. von Willebrand's disease), tranexamic acid is often given.[44] It has also been recommended for people with acquired bleeding disorders (e.g., directly acting oral anticoagulants (DOACs)) to treat serious bleeding.[45]


The use of tranexamic acid, applied directly to the area that is bleeding or taken by mouth, appears useful to treat nose bleeding compared to packing the nose with cotton pledgets alone.[46][47][48] It decreases the risk of rebleeding within 10 days.[49]

Cosmetic Uses[edit]

Tranexamic acid can be used in skincare products as a cosmetic active to reduce the appearance of inflammation and hyperpigmentation.[citation needed] Tranexamic acid is a zwitterion amino acid, and has a low permeability coefficient in the stratum corneum.[50] Tranexamic acid can be combined with penetration enhancers and microneedling to overcome this limitation.[51] Cosmetic uses may also employ lipophilic derivatives of tranexamic acid (ester prodrugs like Cetyl tranexamate mesylate) that are not zwitterionic and thus have improved skin permeability.[52][53][54]


  • Allergic to tranexamic acid
  • History of seizures
  • History of venous or arterial thromboembolism or active thromboembolic disease
  • Severe kidney impairment due to accumulation of the medication, dose adjustment is required in mild or moderate kidney impairment[6]

Adverse effects[edit]

Side effects are rare.[2] Some reported adverse events include seizures, changes in color vision, blood clots, and allergic reactions such as anaphylaxis.[2] Whether the risk of venous thromboembolism (blood clots) is actually increased is a matter of debate. The risk is mentioned in the product literature,[4] and they were reported in post marketing experience.[4] Despite this, and the inhibitory effect of tranexamic acid on blood clot breakdown, large studies of the use of tranexamic acid have not shown an increase in the risk of venous or arterial thrombosis,[55][56] even in people who had previously experienced thrombosis under other circumstances.[56]

Special populations[edit]

  • For pregnancy, no harm has been found in animal studies.[4]
  • Small amounts appear in breast milk if taken during lactation.[4][57]

Society and culture[edit]

Tranexamic acid was first synthesized in 1962 by Japanese researchers Shosuke and Utako Okamoto.[12] It is on the World Health Organization's List of Essential Medicines.[13]

Brand names[edit]

Tranexamic acid is marketed in the US and Australia in tablet form as Lysteda[4] and in Australia, Sweden[58] and Jordan it is marketed in an IV form and tablet form as Cyklokapron, in the UK and Sweden[58] as Cyclo-F. In the UK it is also marketed as Femstrual, in Asia as Transcam, in Bangladesh as Intrax & Tracid, in India as Pause, in Pakistan as Transamin, in South America as Espercil, in Japan as Nicolda, in France, Poland, Belgium and Romania as Exacyl and in Egypt as Kapron. In the Philippines, its capsule form is marketed as Hemostan and in Israel as Hexakapron.[citation needed]

Legal status[edit]

The US Food and Drug Administration (FDA) approved tranexamic acid oral tablets (brand name Lysteda) for treatment of heavy menstrual bleeding in November 2009.[4][59][60]

In March 2011, the status of tranexamic acid for the treatment of heavy menstrual bleeding was changed in the UK, from POM (Prescription only Medicines) to P (Pharmacy Medicines)[61] and became available over the counter in UK pharmacies under the brand names of Cyklo-F and Femstrual.[62]


Tranexamic acid might alleviate neuroinflammation in some experimental settings.[63]

Tranexamic acid can be used in case of postpartum hemorrhage; it can decrease the risk of death due to bleeding by one third according to the WHO.[64]

Tentative evidence supports the use of tranexamic acid in hemoptysis.[65][66]

In hereditary angioedema[67]

In hereditary hemorrhagic telangiectasia: tranexamic acid has been shown to reduce frequency of epistaxis in patients with severe and frequent nosebleed episodes from hereditary hemorrhagic telangiectasia.[68]

In melasma: tranexamic acid is sometimes used in skin whitening as a topical agent, injected into a lesion, or taken by mouth, both alone and as an adjunct to laser therapy; as of 2017 its safety seemed reasonable but its efficacy for this purpose was uncertain because there had been no large scale randomized controlled studies nor long term follow-up studies.[69][70] It is allowed as a quasi-drug for skin whitening in Japan.[71]

In hyphema: tranexamic acid has been shown to be effective in reducing risk of secondary hemorrhage outcomes in people with traumatic hyphema.[72]


  1. ^ "Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017". Therapeutic Goods Administration (TGA). 21 June 2022. Archived from the original on 6 July 2023. Retrieved 30 March 2024.
  2. ^ a b c d e f g "Cyklokapron Tablets - Summary of Product Characteristics (SPC) - (eMC)". emc. September 2016. Archived from the original on 20 December 2016. Retrieved 14 December 2016.
  3. ^ "Evana Heavy Period Relief Summary of Product Characteristics (SmPC)". (emc). 24 April 2024. Retrieved 14 May 2024.
  4. ^ a b c d e f g h i j "Lysteda- tranexamic acid tablet". DailyMed. 2 December 2021. Archived from the original on 29 March 2021. Retrieved 14 May 2024.
  5. ^ 会議事録 [Minutes of the meeting]. 薬事・食品衛生審議会一般用医薬品部会 (in Japanese). 22 March 2007. Archived from the original on 7 September 2022. Retrieved 7 September 2022.
  6. ^ a b c d British national formulary: BNF 69 (69 ed.). British Medical Association. 2015. p. 170. ISBN 978-0-85711-156-2.
  7. ^ a b Shakur H, Roberts I, Fawole B, Chaudhri R, El-Sheikh M, Akintan A, et al. (WOMAN Trial Collaborators) (2017). "Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial". Lancet. 389 (10084): 2105–2116. doi:10.1016/S0140-6736(17)30638-4. PMC 5446563. PMID 28456509.
  8. ^ Law RH, Wu G, Leung EW, Hidaka K, Quek AJ, Caradoc-Davies TT, et al. (2017). "X-ray crystal structure of plasmin with tranexamic acid-derived active site inhibitors". Blood Advances. 1 (12): 766–771. doi:10.1182/bloodadvances.2016004150. PMC 5728053. PMID 29296720.
  9. ^ Wu G, Mazzitelli BA, Quek AJ, Veldman MJ, Conroy PJ, Caradoc-Davies TT, et al. (2019). "Tranexamic acid is an active site inhibitor of urokinase plasminogen activator". Blood Advances. 3 (5): 729–733. doi:10.1182/bloodadvances.2018025429. PMC 6418500. PMID 30814058.
  10. ^ "Tranexamic acid Use During Pregnancy". Drugs.com. Archived from the original on 21 December 2016. Retrieved 14 December 2016.
  11. ^ "Tranexamic Acid Injection - FDA prescribing information, side effects and uses". Drugs.com. Archived from the original on 21 December 2016. Retrieved 14 December 2016.
  12. ^ a b Watts G (2016). "Utako Okamoto". Lancet. 387 (10035): 2286. doi:10.1016/S0140-6736(16)30697-3. PMID 27308678.
  13. ^ a b World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
  14. ^ Hamilton R (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 415. ISBN 978-1-284-05756-0.
  15. ^ Binz S, McCollester J, Thomas S, Miller J, Pohlman T, Waxman D, et al. (2015). "CRASH-2 Study of Tranexamic Acid to Treat Bleeding in Trauma Patients: A Controversy Fueled by Science and Social Media". Journal of Blood Transfusion. 2015: 874920. doi:10.1155/2015/874920. PMC 4576020. PMID 26448897.
  16. ^ Melvin JS, Stryker LS, Sierra RJ (2015). "Tranexamic Acid in Hip and Knee Arthroplasty". The Journal of the American Academy of Orthopaedic Surgeons. 23 (12): 732–40. doi:10.5435/JAAOS-D-14-00223. PMID 26493971. S2CID 41823501.
  17. ^ a b Tengborn L, Blombäck M, Berntorp E (2015). "Tranexamic acid--an old drug still going strong and making a revival". Thrombosis Research. 135 (2): 231–42. doi:10.1016/j.thromres.2014.11.012. PMID 25559460.
  18. ^ Roberts I, Shakur H, Coats T, Hunt B, Balogun E, Barnetson L, et al. (March 2013). "The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients". Health Technology Assessment. 17 (10): 1–79. doi:10.3310/hta17100. PMC 4780956. PMID 23477634.
  19. ^ Ker K, Roberts I, Shakur H, Coats TJ (May 2015). "Antifibrinolytic drugs for acute traumatic injury". The Cochrane Database of Systematic Reviews. 2015 (5): CD004896. doi:10.1002/14651858.CD004896.pub4. PMC 10589907. PMID 25956410.
  20. ^ Cherkas D (November 2011). "Traumatic hemorrhagic shock: advances in fluid management". Emergency Medicine Practice. 13 (11): 1–19, quiz 19–20. PMID 22164397. Archived from the original on 18 January 2012.
  21. ^ "Drug will save lives of accident victims, says study". BBC News Online. 2010. Archived from the original on 24 June 2010. Retrieved 3 June 2016.
  22. ^ Napolitano LM, Cohen MJ, Cotton BA, Schreiber MA, Moore EE (June 2013). "Tranexamic acid in trauma: how should we use it?". The Journal of Trauma and Acute Care Surgery. 74 (6): 1575–1586. doi:10.1097/TA.0b013e318292cc54. PMID 23694890. S2CID 9569603.
  23. ^ CRASH-3 trial collaborators, et al. (CRASH-3 trial collaborators) (November 2019). "Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial". Lancet. 394 (10210): 1713–1723. doi:10.1016/S0140-6736(19)32233-0. PMC 6853170. PMID 31623894. {{cite journal}}: |author1= has generic name (help)CS1 maint: numeric names: authors list (link)
  24. ^ Lukes AS, Moore KA, Muse KN, Gersten JK, Hecht BR, Edlund M, et al. (2010). "Tranexamic acid treatment for heavy menstrual bleeding: a randomized controlled trial". Obstetrics and Gynecology. 116 (4): 865–75. doi:10.1097/AOG.0b013e3181f20177. PMID 20859150. S2CID 6977827.
  25. ^ Naoulou B, Tsai MC (2012). "Efficacy of tranexamic acid in the treatment of idiopathic and non-functional heavy menstrual bleeding: a systematic review". Acta Obstetricia et Gynecologica Scandinavica. 91 (5): 529–37. doi:10.1111/j.1600-0412.2012.01361.x. PMID 22229782. S2CID 8862324.
  26. ^ Kai J, Dutton B, Vinogradova Y, Hilken N, Gupta J, Daniels J (October 2023). "Rates of medical or surgical treatment for women with heavy menstrual bleeding: the ECLIPSE trial 10-year observational follow-up study". Health Technology Assessment. 27 (17): 1–50. doi:10.3310/JHSW0174. PMC 10641716. PMID 37924269.
  27. ^ "The coil and medicines are both effective long-term treatments for heavy periods". NIHR Evidence. 8 March 2024. doi:10.3310/nihrevidence_62335. Archived from the original on 18 March 2024. Retrieved 12 April 2024.
  28. ^ "Postpartum Haemorrhage, Prevention and Management (Green-top Guideline No. 52)". Royal College of Obstetricians & Gynaecologists-US. Archived from the original on 19 January 2019. Retrieved 16 January 2018.
  29. ^ a b Henry DA, Carless PA, Moxey AJ, O'Connell D, Stokes BJ, Fergusson DA, et al. (The Cochrane Collaboration) (2011). Henry DA (ed.). "Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion". The Cochrane Database of Systematic Reviews. 2011 (3). John Wiley & Sons, Ltd: CD001886. doi:10.1002/14651858.cd001886.pub4. PMC 4234031. PMID 21412876.
  30. ^ Ker K, Edwards P, Perel P, Shakur H, Roberts I (2012). "Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis". BMJ. 344: e3054. doi:10.1136/bmj.e3054. PMC 3356857. PMID 22611164.
  31. ^ Ker K, Prieto-Merino D, Roberts I (2013). "Systematic review, meta-analysis and meta-regression of the effect of tranexamic acid on surgical blood loss" (PDF). The British Journal of Surgery. 100 (10): 1271–9. doi:10.1002/bjs.9193. PMID 23839785. S2CID 25033742. Archived (PDF) from the original on 8 August 2019. Retrieved 8 August 2019.
  32. ^ RCPCH. "Evidence Statement Major trauma and the use of tranexamic acid in children Nov 2012" (PDF). Retrieved 17 December 2012.[permanent dead link]
  33. ^ Sethna NF, Zurakowski D, Brustowicz RM, Bacsik J, Sullivan LJ, Shapiro F (2005). "Tranexamic acid reduces intraoperative blood loss in pediatric patients undergoing scoliosis surgery". Anesthesiology. 102 (4): 727–32. doi:10.1097/00000542-200504000-00006. PMID 15791100. S2CID 790638.
  34. ^ Pernik MN, Dosselman LJ, Aoun SG, Walker AD, Hall K, Peinado Reyes V, et al. (2020). "The effectiveness of tranexamic acid on operative and perioperative blood loss in long-segment spinal fusions: a consecutive series of 119 primary procedures". Journal of Neurosurgery. Spine. 32 (5): 768–774. doi:10.3171/2019.11.SPINE191174. PMID 31978874.
  35. ^ "Cyklokapron (tranexamic acid) Product Information" (PDF). Archived from the original (PDF) on 29 February 2016. Retrieved 3 November 2015.
  36. ^ Forbes CD, Barr RD, Reid G, Thomson C, Prentice CR, McNicol GP, et al. (1972). "Tranexamic acid in control of haemorrhage after dental extraction in haemophilia and Christmas disease". British Medical Journal. 2 (5809): 311–3. doi:10.1136/bmj.2.5809.311. PMC 1788188. PMID 4553818.
  37. ^ van Galen KP, Engelen ET, Mauser-Bunschoten EP, van Es RJ, Schutgens RE (2019). "Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions". The Cochrane Database of Systematic Reviews. 2019 (4): CD011385. doi:10.1002/14651858.CD011385.pub3. PMC 6474399. PMID 31002742.
  38. ^ Chen Z. "牙膏可添加氨甲环酸" [Tranexamic acid is allowed in toothpastes]. People's Daily Online, Health Section (in Chinese). Archived from the original on 7 September 2022. Retrieved 7 September 2022.
  39. ^ "LC Paper No. CB(3) 61/07-08 Proposed resolution under the Pharmacy and Poisons Ordinance" (PDF). Hong Kong LegCo. 7 November 2007. Archived (PDF) from the original on 7 September 2022. Retrieved 7 September 2022.
  40. ^ "牙膏含"氨甲环酸"是处方药?看看牙膏里的秘密" [TXA in toothpaste a prescription drug? Secrets of toothpastes]. news.sina.com.cn. 中国新闻周刊 [China News Weekly]. 31 October 2018. Archived from the original on 7 September 2022. Retrieved 7 September 2022.
  41. ^ "How to Choose Toothpaste". ion Corporation. Archived from the original on 7 September 2022. Retrieved 7 September 2022. if toothpaste has a label of "quasi drug", this indicates that the product contains active ingredients [...] Tranexamic acid
  42. ^ "Unauthorized". Health Canada. Government of Canada. 4 October 2019. Archived from the original on 5 December 2019. Retrieved 30 July 2020.
  43. ^ a b Estcourt LJ, Desborough M, Brunskill SJ, Doree C, Hopewell S, Murphy MF, et al. (2016). "Antifibrinolytics (lysine analogues) for the prevention of bleeding in people with haematological disorders". The Cochrane Database of Systematic Reviews. 2016 (3): CD009733. doi:10.1002/14651858.CD009733.pub3. PMC 4838155. PMID 26978005.
  44. ^ "Tranexamic acid". Clinical Transfusion. International Society of Blood Transfusion (ISBT). Archived from the original on 17 January 2018. Retrieved 16 January 2018.
  45. ^ Siegal DM, Garcia DA, Crowther MA (2014). "How I treat target-specific oral anticoagulant-associated bleeding". Blood. 123 (8): 1152–8. doi:10.1182/blood-2013-09-529784. PMID 24385535.
  46. ^ Ker K, Beecher D, Roberts I (2013). Ker K (ed.). "Topical application of tranexamic acid for the reduction of bleeding" (PDF). The Cochrane Database of Systematic Reviews (7): CD010562. doi:10.1002/14651858.CD010562.pub2. PMID 23881695. Archived (PDF) from the original on 27 April 2019. Retrieved 30 November 2019.
  47. ^ Logan JK, Pantle H (2016). "Role of topical tranexamic acid in the management of idiopathic anterior epistaxis in adult patients in the emergency department". American Journal of Health-System Pharmacy. 73 (21): 1755–1759. doi:10.2146/ajhp150829. PMID 27769971.
  48. ^ Williams A, Biffen A, Pilkington N, Arrick L, Williams RJ, Smith ME, et al. (2017). "Haematological factors in the management of adult epistaxis: systematic review". The Journal of Laryngology and Otology. 131 (12): 1093–1107. doi:10.1017/S0022215117002067. PMID 29280698. S2CID 45310419.
  49. ^ Gottlieb M, Koyfman A, Long B (2019). "Tranexamic Acid for the Treatment of Epistaxis". Academic Emergency Medicine. 26 (11): 1292–1293. doi:10.1111/acem.13760. PMID 30933392.
  50. ^ Hatanaka T, Kamon T, Uozumi C, Morigaki S, Aiba T, Katayama K, et al. (July 1996). "Influence of pH on skin permeation of amino acids". The Journal of Pharmacy and Pharmacology. 48 (7): 675–9. doi:10.1111/j.2042-7158.1996.tb03949.x. PMID 8866327.
  51. ^ Ziaeifar E, Ziaeifar F, Mozafarpoor S, Goodarzi A (November 2021). "Applications of microneedling for various dermatologic indications with a special focus on pigmentary disorders: A comprehensive review study". Dermatologic Therapy. 34 (6): e15159. doi:10.1111/dth.15159. PMID 34657363.
  52. ^ Vávrová K, Hrabálek A, Dolezal P, Holas T, Klimentová J (May 2005). "Biodegradable derivatives of tranexamic acid as transdermal permeation enhancers". Journal of Controlled Release. 104 (1): 41–9. doi:10.1016/j.jconrel.2005.01.002. PMID 15866333.
  53. ^ Bundgaard H (January 1989). "The double prodrug concept and its applications". Advanced Drug Delivery Reviews. 3 (1): 39–65. doi:10.1016/0169-409x(89)90004-5.
  54. ^ Zhang Q, Grice JE, Wang G, Roberts MS (March 2009). "Cutaneous metabolism in transdermal drug delivery". Current Drug Metabolism. 10 (3): 227–35. doi:10.2174/138920009787846350. PMID 19442085.
  55. ^ Chornenki NL, Um KJ, Mendoza PA, Samienezhad A, Swarup V, Chai-Adisaksopha C, et al. (2019). "Risk of venous and arterial thrombosis in non-surgical patients receiving systemic tranexamic acid: A systematic review and meta-analysis". Thrombosis Research. 179: 81–86. doi:10.1016/j.thromres.2019.05.003. PMID 31100632. S2CID 157066652.
  56. ^ a b Taeuber I, Weibel S, Herrmann E, Neef V, Schlesinger T, Kranke P, et al. (April 2021). "Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality: A Systematic Review, Meta-analysis, and Meta-regression". JAMA Surgery. 156 (6): e210884. doi:10.1001/jamasurg.2021.0884. PMC 8047805. PMID 33851983.
  57. ^ "Tranexamic Acid use while Breastfeeding". www.drugs.com. 2014. Archived from the original on 18 September 2016. Retrieved 27 May 2016.
  58. ^ a b "Substans - Tranexamsyra". FASS. FASS.se. Archived from the original on 19 April 2021. Retrieved 19 April 2021.
  59. ^ "Drug Approval Package: Lysteda (tranexamic acid) NDA #022430". U.S. Food and Drug Administration (FDA). 6 May 2010. Archived from the original on 16 April 2024. Retrieved 14 May 2024.
  60. ^ "Xanodyne Announces FDA Approval of Lysteda (Tranexamic Acid) for Treatment of Women with Heavy Menstrual Bleeding". Drugs.com (Press release). Archived from the original on 31 July 2022. Retrieved 11 December 2020.
  61. ^ Chapman C (27 January 2011). "Tranexamic Acid to be available OtC". Community pharmacy news, analysis and CPD. Archived from the original on 9 October 2011.
  62. ^ Chapman C (10 February 2011). "In defence of multiple pharmacies". Community pharmacy news, analysis and CPD. Archived from the original on 28 March 2012.
  63. ^ Atsev S, Tomov N (2020). "Using antifibrinolytics to tackle neuroinflammation". Neural Regeneration Research. 15 (12): 2203–2206. doi:10.4103/1673-5374.284979. PMC 7749481. PMID 32594031.
  64. ^ "WHO | WHO updates recommendation on intravenous tranexamic acid for the treatment of postpartum haemorrhage". Archived from the original on 9 July 2021. Retrieved 23 August 2020.
  65. ^ Moen CA, Burrell A, Dunning J (2013). "Does tranexamic acid stop haemoptysis?". Interactive Cardiovascular and Thoracic Surgery. 17 (6): 991–4. doi:10.1093/icvts/ivt383. PMC 3829500. PMID 23966576.
  66. ^ Prutsky G, Domecq JP, Salazar CA, Accinelli R (2016). "Antifibrinolytic therapy to reduce haemoptysis from any cause". The Cochrane Database of Systematic Reviews. 2016 (11): CD008711. doi:10.1002/14651858.CD008711.pub3. PMC 6464927. PMID 27806184. Archived from the original on 5 July 2018. Retrieved 5 July 2018.
  67. ^ Flower R, Rang HP, Dale MM, Ritter JM (2007). Rang & Dale's pharmacology. Edinburgh: Churchill Livingstone. ISBN 978-0-443-06911-6.[page needed]
  68. ^ Klepfish A, Berrebi A, Schattner A (2001). "Intranasal tranexamic acid treatment for severe epistaxis in hereditary hemorrhagic telangiectasia". Archives of Internal Medicine. 161 (5): 767. doi:10.1001/archinte.161.5.767. PMID 11231712.
  69. ^ Zhou LL, Baibergenova A (2017). "Melasma: systematic review of the systemic treatments". International Journal of Dermatology. 56 (9): 902–908. doi:10.1111/ijd.13578. PMID 28239840. S2CID 21683251.
  70. ^ Taraz M, Niknam S, Ehsani AH (May 2017). "Tranexamic acid in treatment of melasma: A comprehensive review of clinical studies". Dermatologic Therapy. 30 (3): e12465. doi:10.1111/dth.12465. PMID 28133910. S2CID 3910189.
  71. ^ Ando H, Matsui MS, Ichihashi M (June 2010). "Quasi-drugs developed in Japan for the prevention or treatment of hyperpigmentary disorders". International Journal of Molecular Sciences. 11 (6): 2566–2575. doi:10.3390/ijms11062566. PMC 2904932. PMID 20640168.
  72. ^ Woreta FA, Lindsley KB, Gharaibeh A, Ng SM, Scherer RW, Goldberg MF (March 2023). "Medical interventions for traumatic hyphema". The Cochrane Database of Systematic Reviews. 2023 (3): CD005431. doi:10.1002/14651858.CD005431.pub5. PMC 10010597. PMID 36912744.